<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Manuel S. Enverga University : Web-based Integrated Information System</title>
<link rel="shortcut icon" href="{dir_image}favicon.ico">
<link rel="stylesheet" type="text/css" href="{dir_css}Popup.css" />

<script type="text/javascript" src="{dir_js}jquery.min.js"></script>
<script type="text/javascript">
	$(document).ready(function() {
		if( $('#saved_record').val() == 1 ) {
			alert('Request for student change password has been successfully send.');
			parent.popupRequest('hide');
			return false;
		}
	});
</script>

</head>
<body>

	<div class="title-frame">Forgot Password?</div>
	<div class="title-sub">
		In order to recover your password, we need to confirm you identity.<br />
		Enter Your Valid Student Number, Whole Name, E-mail Address and Message.
	</div>
	<div class="popup-spacer"></div>
	<input type="hidden" id="saved_record" value="{saved_record}"/>
	<form method="post" enctype="multipart/form-data" action="">
		<table width="530" border="0" cellspacing="0" cellpadding="0">
			<tr>
				<td width="100" height="28">Student #<span class="required-field">*</span></td>
				<td width="10">:</td>
				<td width="420"><input type="text" name="txtstudno" class="text-input" value="{txtstudno}"/> <span class="required-field">{w_txtstudno}</span></td>
			</tr>
			<td height="28">First Name<span class="required-field">*</span></td>
				<td>:</td>
				<td><input type="text" name="txtfname" class="text-input" value="{txtfname}"/> <span class="required-field">{w_txtfname}</span></td>
			</tr>
			<tr>
				<td height="28">Middle Name<span class="required-field">*</span></td>
				<td>:</td>
				<td><input type="text" name="txtmname" class="text-input" value="{txtmname}" /> <span class="required-field">{w_txtmname}</span></td>
			</tr>
			<tr>
				<td height="28">Last Name<span class="required-field">*</span></td>
				<td>:</td>
				<td><input type="text" name="txtlname" class="text-input" value="{txtlname}" /> <span class="required-field">{w_txtlname}</span></td>
			</tr>
			<tr>
				<td height="28">E-mail Addres<span class="required-field">*</span></td>
				<td>:</td>
				<td><input type="text" name="txtemail" class="text-input" value="{txtemail}"/> <span class="required-field">{w_txtemail}</span></td>
			</tr>
			<tr>
				<td height="58">Message <span class="required-field">*</span></td>
				<td>:</td>
				<td><textarea name="txtmessage" class="textarea-input">{txtmessage}</textarea> <div class="required-field">{w_txtmessage}</div></td>
			</tr>
			<tr>
				<td height="10" colspan="3"></td>
			</tr>
			<tr>
				<td height="28"></td>
				<td></td>
				<td><input type="submit" name="subButton" class="submit-input" value="Send Request"/></td>
			</tr>
		</table>
	</form>
	<div class="popup-spacer"></div>
	<div class="message-content">
		An e-mail has been sent to you from registrar office that contains your reset password.
		If you didn't receive any email within 48 hours, go to registrar office.
	</div>

</body>
</html>
